Objective
To improve quality of care of complex, post-cardiac surgery patients by reducing omissions in information exchanged during handover, without significantly prolonging handover duration.

Methods
An interdisciplinary group developed a fill-in-the-blank, one-page tool to guide information exchange between the OR and PICU teams, during handover of post-cardiac surgery patients. The tool consists of four categories of information: preoperative (7 elements), medical intra-operative (14 elements), surgical intra-operative (11 elements) and current status (11 elements). We conducted a prospective, interventional study to establish the tool’s impact on information exchanged overall(total score) and in the four categories (4 subscores). One investigator directly observed all handovers, scored them with a checklist (1 point per element if discussed) and timed their duration.

Results
The pre and post-intervention groups were similar at baseline. There was a significant improvement in the total handover score after the implementation of the handover tool (28.2+/- 4.6 vs. 33.5+/- 3.7 points, p= 0.002). In addition, there was a significant improvement in the medical (8.3+/-2.6 vs 10.3 +/- 2.1 points, p=0.024) and surgical (7.5 +/- 1.4 vs 9.3+/- 1.6 points, p= 0.002) intraoperative subscores. The preoperative and current status scores did not change. There was no considerable increase in handover duration when using this tool (8.3+/-4.6 vs 11.1 +/- 3.9 minutes, p=0.1).

Conclusions
Use of a simple tool, during handover of post-cardiac surgery patients, resulted in a more complete exchange of critical information with no significant prolongation of the handover duration.